title: A retrospective study on IVF/ICSI outcome in patients with anti-nuclear antibodies: the effects of prednisone plus low-dose aspirin adjuvant treatment.
abstract: BACKGROUND
  Anti-nuclear antibodies (ANA) are suspected of having relevance to adverse reproductive events.
  
  
  METHODS
  This study aims to investigate the potential effect of ANA on IVF/ICSI outcome and the therapeutic role of prednisone plus low-dose aspirin (P + A) adjuvant treatment in ANA + patients. The first IVF/ICSI cycles without P + A of sixty-six ANA + women were enrolled as the ANA + group, and the 233 first IVF/ICSI cycles of matched ANA- women served as the ANA- group. The ANA + group was divided into the Titre < =1:320 subgroup and the Titre > 1:320 subgroup. Twenty-one ANA + women with adverse outcomes in their first cycles (ANA + cycles without P + A) received P + A adjuvant treatment for three months before the second IVF/ICSI cycle (ANA + cycles with P + A). The clinical characteristics and the IVF/ICSI outcomes were compared, respectively, between 1) the ANA + group and the ANA- group, 2) the Titre < =1:320 subgroup and the Titre > 1:320 subgroup, and 3) the ANA + cycles without P + A and the ANA + cycles with P + A.
  
  
  RESULTS
  No significant differences were observed between each of the two-group pairs in the clinical characteristics. The ANA + group exhibited significantly lower MII oocytes rate, normal fertilisation, pregnancy and implantation rates, as well as remarkably higher abnormal fertilisation and early miscarriage rates. The Titre < =1:320 subgroup's IVF/ICSI outcomes were as poor as those of the Titre > 1:320 subgroup. After the P + A adjuvant treatment, the number of two pro-nuclei, perfect embryos and available embryos, and the implantation rate increased significantly.
  
  
  CONCLUSIONS
  These observations suggest that ANA could exert a detrimental effect on IVF/ICSI outcome that might not be titre-dependent, and P + A adjuvant treatment could be useful for ANA + patients. This hypothesis should be verified in further prospective randomised studies.
authors.affiliation: Centre for Reproductive Medicine, Department of Obstetrics and Gynecology, Anhui Provincial Hospital affiliated with Anhui Medical University, Hefei, Anhui 230000, China. shengzhizhongxin@126.com.
authors.forename: Qing
authors.initials: Q
authors.lastname: Zhu
authors.forename: Li
authors.initials: L
authors.lastname: Wu
authors.forename: Bo
authors.initials: B
authors.lastname: Xu
authors.forename: Mei-Hong
authors.initials: MH
authors.lastname: Hu
authors.forename: Xian-Hong
authors.initials: XH
authors.lastname: Tong
authors.forename: Jing-Juan
authors.initials: JJ
authors.lastname: Ji
authors.forename: Yu-Sheng
authors.initials: YS
authors.lastname: Liu
mesh_terms: D000022:Abortion, Spontaneous; D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood*; D001241:Aspirin / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D011241:Prednisone / Q000627:therapeutic use*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies
chemical_list: D000974:Antibodies, Antinuclear; D001241:Aspirin; D011241:Prednisone